We all benefit from regular dental care, regardless of our state of oral health. But if you've experienced periodontal (gum) disease, those regular dental visits are even more important in making sure your healed gums stay that way.
Gum disease is a bacterial infection caused by dental plaque, a thin film of bacteria and food particles accumulating on tooth surfaces. The infection triggers inflammation in the gums that quickly becomes chronic. That's why people with gum disease have reddened and swollen gums that bleed easily.
The infection can aggressively spread deeper below the gum line, eventually affecting the bone. The combination of weakened gum detachment from the teeth and bone loss may ultimately cause tooth loss. But we can stop the infection by thoroughly removing all plaque and tartar (hardened plaque) from the teeth and gums. As the plaque is removed, the gums respond and begin to heal.
It's possible then even with advanced gum disease to restore health to your teeth and gums. But although the infection has been arrested, it can occur again. In fact, once you've had gum disease, your susceptibility for another infection is much greater. To stay on top of this, you may need to visit the dentist more frequently.
These upgraded visits known as periodontal maintenance (PM) are actually a continuation of your treatment. Depending on the extensiveness of your gum disease, we may need to see you more than the standard twice-a-year visits: Some periodontal patients, for example, may need a visit every two to three months. Again, the state of your gum health will determine how often.
In addition to standard dental cleanings and checkups, PM visits will also include more thorough examination of the teeth and gums, particularly the health of the tooth roots. We'll also check how well you're doing with daily plaque removal and if there are any signs of gum infection. We may also prescribe medication, rinses or topical antibiotics to help control your mouth's levels of bacteria.
A patient's periodontal “maintenance schedule” will depend on their individual condition and needs. The key, though, is to closely monitor gum health for any indications that another infection has set in. By staying alert through dedicated PM, we can stop a new infection before it harms your dental health.
If you would like more information on gum disease, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Periodontal Cleanings.”
Millions of Americans rely on dental insurance to help them better afford dental care. Depending on the benefit package, an insurance policy can be useful in restoring dental health compromised by disease or injury.
But how life-like that restoration may appear is often a secondary concern with many insurance plans. For example, dental insurance will pay for a crown restoration that restores function to a tooth, but not necessarily of the highest aesthetic quality for achieving a truly life-like appearance.
To be sure, not all dental crowns are the same. Some are all metal, usually gold or silver. Some are “hybrids,” made of an interior metal shell with an outer fused porcelain shell (porcelain-fused-to-metal or PFM). In recent years all -ceramic crowns made of stronger life-like ceramics have become the most popular.
The type of crown used will depend a great deal on the type and location of the tooth. Teeth on the back of the jaw that encounter greater biting forces and are not as noticeable in the smile may do better with a metal or PFM crown. Visible side and front teeth are more likely candidates for all-ceramic. Your dentist will give you your best options as it pertains to your dental needs and appearance.
There's also a difference in crown workmanship. Dental laboratories now use milling machinery that sculpts a crown from a single block of material. Although some final handwork by skilled technicians is still necessary, milling has streamlined the process—and the cost—for producing a crown of high functioning quality.
But crowns that achieve the most natural smile appearance require more in the way of artistic craftsmanship. This in turn can increase the crown's price—beyond what many dental policies agree to cover. You may then be faced with a decision: an insurance-covered functional crown with an acceptable level of life-likeness or a more life-like crown for which you may have to pay more out-of-pocket.
Your dentist can advise you on your best options for a crown restoration, also factoring in what your insurance will cover. Ultimately, though, you'll have to weigh the kind of smile you desire with your dental situation and finances.
If you would like more information on dental crown restorations, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Porcelain Dental Crowns.”
Enamel is the hardest substance in the human body, and for good reason—it's your teeth's first line of defense against wearing and harmful oral bacteria. But although enamel can “take a licking and keep on ticking,” it can lose its mineral content, soften and eventually erode to expose the teeth to bacteria.
Here are 4 tips for protecting your enamel so it keeps on protecting you.
Practice sound brushing techniques. Brushing is necessary for removing bacterial plaque that can trigger dental disease. But how you brush could prove not only ineffective, but also harmful to your enamel. So, be sure you're brushing all tooth surfaces, but not too forcefully or too often (twice a day is enough)—otherwise, you could wear down enamel and damage your gums.
Wait to brush after eating. The acid levels in the mouth go up during eating, causing an immediate softening of enamel. But saliva then goes to work neutralizing acid and helping to restore enamel's mineral content. Since it takes saliva about thirty minutes to an hour to complete this task, wait on brushing at least that long. Otherwise, you might remove tiny traces of temporarily softened enamel.
Avoid eating right before bed. While we sleep, our saliva flow decreases until we wake up. If you eat just before bed, you may not be giving your saliva enough time to neutralize acid before it “goes to sleep” with you for the night. So, give your saliva ample time to neutralize any remaining acid by not eating anymore at least an hour before you turn in.
Limit drinking acidic beverages. Some of our favorite drinks—sodas, energy and sports drinks, and even some juices—can be high in acid. To protect your enamel, reduce your consumption of these types of beverages in favor of water or milk (the calcium in the latter will also benefit your enamel). When you do drink acidic beverages, use a straw to minimize contact of the fluid with your enamel.
Healthy and strong enamel is the key to healthy and strong teeth. It's worth taking these steps to protect this important defense against destructive tooth decay.
If you would like more information on personal dental care, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “6 Tips to Help Prevent the Erosion of Tooth Enamel.”
We're all tempted occasionally to use our teeth in ways that might risk damage. Hopefully, though, you've never considered anything close to what singer, songwriter and now social media persona Jason Derulo recently tried in a TikTok video—attempting to eat corn on the cob spinning on a power drill. The end result seemed to be a couple of broken front teeth, although many of his followers suspected an elaborate prank.
Prank or not, subjecting your teeth to “motorized corn”—or a host of other less extreme actions or habits—is not a good thing, especially if you have veneers, crowns or other dental work. Although teeth can withstand a lot, they're not invincible.
Here, then, are four things you should do to help ensure your teeth stay healthy, functional and intact.
Clean your teeth daily. Strong teeth are healthy teeth, so you want to do all you can to prevent tooth decay or gum disease. Besides semi-annual dental cleanings, the most important thing you can do is to brush and floss your teeth daily. These hygiene tasks help remove dental plaque, a thin biofilm that is the biggest culprit in dental disease that could weaken teeth and make them more susceptible to injury.
Avoid biting on hard objects. Teeth's primary purpose is to break down food for digestion, not to break open nuts or perform similar tasks. You should also avoid habitual chewing on hard objects like pencils, nails or ice to relieve stress. And, you may need to be careful eating apples or other foods with hard surfaces if you have veneers or composite bonding on your teeth.
Wear a sports mouthguard. If you or a family member are regularly involved with sports like basketball, baseball/softball or football (even informally), you can protect your teeth from facial blows by wearing an athletic mouthguard. Although you can obtain a retail variety in most stores selling sporting goods, a custom-made guard by a dentist offers the best protection and comfort.
Visit your dentist regularly. As mentioned before, semi-annual dental cleanings help remove hidden plaque and tartar and further minimize your risk of disease. Regular dental visits also give us a chance to examine your mouth for any signs of decay or gum disease, and to check on your dental health overall. Optimizing your dental health plays a key part in preventing dental damage.
You should expect an unpleasant outcome involving your teeth with power tools. But a lot less could still damage them: To fully protect your dental health, be sure you practice daily oral care, avoid tooth contact with hard objects and wear a mouthguard for high-risk physical activities.
If you would like more information on caring for your cosmetic dental work, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Porcelain Veneers” and “An Introduction to Sports Injuries & Dentistry.”
Osteoporosis is a serious bone weakening disease in older adults that can turn a minor fall into a major bone fracture. But the condition could also impact dental treatment—triggered ironically by the drugs used to treat osteoporosis rather than the disease itself.
From the Latin for “porous bone,” osteoporosis causes bone to gradually lose mineral structure. Over time the naturally-occurring spaces between mineralized portions of the bone enlarge, leaving it weaker as a result.
Although there's no definitive cure for osteoporosis, a number of drugs developed over the last couple of decades can inhibit its progress. Most fall into two major categories, bisphosphonates and RANKL inhibitors.
These drugs work by inhibiting the normal growth cycle of bone. Living bone constantly changes as cells called osteoblasts produce new bone. A different type, osteoclasts, clear away older bone to make room for these newer cells. The drugs selectively destroy osteoclasts so that the older bone, which would have been removed by them, remains for a longer period of time.
Retaining older cells longer initially slows the disease process. But there is a downside: in time, this older bone kept in place continues to weaken and lose vitality. In rare instances it may eventually become detached from its blood supply and die, resulting in what is known as osteonecrosis.
Osteonecrosis mostly affects two particular bones in the body: the femur (the long bone in the upper leg) and the jawbone. In regard to the latter, even the stress of chewing could cause osteonecrosis in someone being treated for osteoporosis. It can also occur after tooth extractions or similar invasive procedures.
If you're taking a bisphosphonate or RANKL inhibitor, you'll want to inform your dentist so that the necessary precautions can be taken before undergoing dental work more invasive than routine cleanings or getting a filling or crown. If you need major dental work, your dentist or you will also need to speak with your physician about stopping the drug for a few months before and after a dental procedure to minimize the risk of osteonecrosis.
Fortunately, the risk for dental problems while undergoing treatment for osteoporosis is fairly low. Still, you'll want to be as prepared as possible so that the management of your osteoporosis doesn't harm your dental health.
If you would like more information on osteoporosis and dental health, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Osteoporosis Drugs & Dental Treatment.”
This website includes materials that are protected by copyright, or other proprietary rights. Transmission or reproduction of protected items beyond that allowed by fair use, as defined in the copyright laws, requires the written permission of the copyright owners.